switching from IUCD (IUC) to combined hormonal contraceptive (CHC)
Last edited 07/2019
| IUC method switching to | Contraceptive method switching from | Timing of IUC insertion | Need for additional precautions | Additional information |
| Cu-IUD | All methods of contraception | Cu-IUD can be inserted at any time if another method of contraception has been used consistently and correctly and it is reasonably certain that the woman is not pregnant or at risk of pregnancy (except in those circumstances that would qualify for use as an EC) | No additional precautions required | Ideally if switching from an LNG-IUS to a Cu-IUD additional contraceptive precautions are advised in the 7 days before changing in case the new method cannot be inserted |
| LNG-IUS | CHC | Week 2 or 3 of CHC cycle or Day 1 of the hormone-free interval | No additional precautions required, providing CHC used correctly for 7 days prior to insertion | There is evidence to suggest that taking hormonally active pills for 7 consecutive days prevents ovulation |
| LNG-IUS | CHC | After Day 1 of the hormone free interval or in Week 1 of CHC cycle | Continue CHC or use other additional contraception for 7 days | Advice for switching during the hormone-free interval may be overcautious but there is a theoretical risk that ovulation may occur as early as Day 10 after stopping CHC, before the LNG-IUS is fully effective |
| LNG-IUS | POP | At any time | Yes, continue POP or use other additional contraception for 7 days | |
| LNG-IUS | Progestogen-only implant | Up to 3 years post-insertion | No | |
| Progestogen-only implant | From 3 years post-insertion | Yes (7 days) | If it is reasonably certain the woman is not pregnant or at risk of pregnancy | |
| LNG-IUS | Progestogen-only injectable | <=14 weeks post-IM or SC injection | No | |
| Progestogen-only injectable | >14 weeks since last IM or SC injection | Yes (7 days) | If it is reasonably certain the woman is not pregnant or at risk of pregnancy | |
| LNG-IUS | Barrier methods | Days 1-7 of the menstrual cycle | No | |
| Barrier methods | After Day 7 of the menstrual cycle | Yes, 7 days | If it is reasonably certain the woman is not pregnant or at risk of pregnancy | |
| LNG-IUS | Cu-IUD | Any time | Yes (7 days) | If sex has occurred in the last 7 days advise to leave Cu-IUD for a further 7 days from that episode and use extra precautions before change to LNG-IUS |
Reference:
- FSRH Guidance (April 2015) Intrauterine Contraception